I injured my fistula, it's clotted, do you recommend having it removed?

I had my transplant a year and half ago but I haven't used this fistula since 2005 because I was on peritoneal dialysis. I was working out with my usual routine but I added a little extra weight and more sets then two days later we had a work day at my church then that night I noticed pain in my upper left arm fistula.

Two days later I went for my monthly belatacept infusion. They use the fistula for the infusion because my other veins are small and it's hard to start an IV in them. They couldn't get a blood return from the fistula so I realized then that it was clotted. They were able to start an IV in my other arm.

I saw a vascular surgeon who told me a declot procedure would be difficult and unnecessary on my "mega fistula" if it was only a matter of having a reliable access to my bloodstream for my monthly blood work and infusions. He said that I should consider having a port placed as a reliable access. He also told me that the pain, swelling, and redness will go away on their own.

I have had at least 10 surgeries over my life not including revisions done to my fistula when I was on hemodialysis. So I opted not to have the declot and I am wondering if I should have this unusable fistula removed from my arm. I will consider having a port placed for my lab work and infusions. But I don't really want to be cut on any more if it is not necessary. Are there any other benefits from having a fistula removed other than "cosmetic"? Thank you.

[Damigi28]

If you are not going to have it declotted, i would have it removed. It is a very simple procedure. I think it will continue to give you problems in the future. It is 13 years old. I would let them remove it. Do you still have your pd catheter in place?

[Hidden in reply to Damigi28]

No they took the catheter out when I had my transplant.

I'm starting to lean towards having it removed. More than one doctor (vascular doctors, cardiologist) have said it could give me problems in the future. Since my veins really are garbage from years of use I'm considering a port and having the fistula removed.